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Background: Studying outcome predictors in patients with onset of cerebral infarction in early adult life may enhance our knowledge of disease pathophysiology and prognosis. Aim: The aim is to identify independent predictors of short-term outcome of first-ever ischemic stroke in young adults with special emphasis on inflammatory and thrombogenic markers. Methods: We enrolled 33 patients aged 19–44 years with first-ever ischemic stroke admitted to Kasr Alainy Stroke Unit and 33 matched controls. Clinical, radiological, and laboratory (adhesion molecules, C-reactive protein, prolactin, and mean platelet volume) evaluations were carried out. Functional outcome at 7 days after stroke onset was assessed using the modified Rankin scale, and independent predictors were identified. Results: The most frequently identified risk factor was cardiac abnormality. Patients exhibited significantly higher levels of baseline inflammatory and thrombogenic markers compared with controls. These markers were significantly correlated with the stroke severity. Logistic regression model showed that high National Institutes of Health Stroke Scale (NIHSS) score (odds ratios [OR] = 0.13; 95% confidence interval [CI], 0.04–0.24; P = 0.01) and large infarction size (OR = 0.11; 95% CI, 0.09–0.17; P = 0.04) but not the laboratory markers were independent predictors of unfavorable outcome. Conclusion: Our data suggested that higher NIHSS scores and large infarction size served as independent predictors of short-term unfavorable outcome, while inflammatory and thrombogenic markers did not. [ABSTRACT FROM AUTHOR]

Background Optical coherence tomography (OCT) is a promising tool for detecting subclinical changes in retinal nerve fiber layer (RNFL) and macular volume in multiple sclerosis (MS). Objectives The aim of the study was to assess the relationship of retinal changes in different MS subtypes with and without optic neuritis (ON) with clinical disability, duration of illness, and MRI results. Methods Twenty-four patients with relapsing-remitting subtype and 12 patients with secondary progressive subtype, of age range 16-55 years, with and without ON, and 16 age-matched and sex-matched healthy controls were enrolled in this study; in total, there were 15 male and 37 female participants. Patients were subjected to history, clinical evaluation, Extended Disability Status Score for disease severity, MRI brain with contrast, and OCT to assess the RNFL and macular volume of the optic nerve. The control group underwent OCT. Results RNFL thinning was highly correlated in both subtypes with and without ON in all field quadrants compared with the healthy controls. In addition, retinal and macular thickness inversely correlated with Extended Disability Status Score and disease duration in the progressive group than in the relapsing-remitting type. MRI with contrast inversely correlated with both macular and RNFL thickness in the progressive type. Conclusion Retinal axonal loss is more prominent in advanced stages of disease with proportionally greater thinning in eyes previously affected by clinically evident ON. In the absence of clinically evident ON, OCT is a promising potential biomarker of retinal pathology in MS subtypes. [ABSTRACT FROM AUTHOR]

Background: Grey matter involvement is suggested to have a role in pathophysiology of multiple sclerosis (MS). Objective: Our aim is to detect the thalamic involvement using 1.5 Tesla Diffusion tensor imaging (DTI) and its relationship with cognitive impairment, clinical disability and fatigue in MS patients. Methods: 31 patients with MS (23 RRMS and 8 SPMS) with mean age 34.4±8.5 SD were studied. We recruited also 18 age, sex and education level matched healthy controls. They all underwent clinical assessment, cognitive assessment using California verbal learning test, brief visuospatial memory test, paced auditory serial addition task (PASAT), symbol digit modalities test, controlled oral word association test, assessment of fatigue using fatigue severity scale, and radiological assessment using 1.5 T DTI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured over regions of interest over the thalamus. Results: Patients with MS had higher thalamic FA (P<0.01) and ADC (P<0.01) than controls. Patients showed significantly worse performance in all cognitive tests than controls. There was significant correlation between total EDSS and mean thalamic FA. In addition, there were good positive correlations between disease duration, number of attacks and mean FA over the thalamus. There were significant correlations between performance in neuropsychological tests, disease duration, number of attacks and total EDSS. Conclusion: DTI was able to detect abnormalities in normal-appearing thalamus of patients with MS. Thalamic involvement had significant relations with cognitive impairment and clinical disability in patients with MS. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease targets the vascular system resulting in vasculitis, vasculopathy, and premature atherosclerosis. Vascular affection is one of the proposed pathogenic mechanisms for neuropsychiatric lupus. Objective: The purpose of this study was to measure the total cerebral blood flow volume (TCBFV) in patients with SLE using Doppler ultrasonography and to determine whether a relationship exists between cerebral perfusion changes with disease activity and cognitive screening tests. Subjects and Methods: This study was conducted on twenty-one SLE female patients diagnosed according to the modified American College of Rheumatology revised criteria of SLE. Ten age-matched female volunteers served as the control group. All subjects were assessed using Modified Mini-Mental State as a neuropsychological screening test. Cerebral blood flow was assessed by extra- cranial Doppler ultrasonography to calculate TCBFV. Results: TCBFV was lower in patients' than in the control group but not statistically significant. A significant lower CBFV in Left Internal Carotid Artery in patients' group compared to the control group (p 0.05). The cerebral perfusion was significantly lower in patients with active disease (p 0.01). There was no statistically significant difference between patients with neuropsychiatric lupus (NPSLE) compared to Non NPSLE or between patients with antiphospholipid syndrome (APS) and without APS; regarding their TCBV .SLE patients had subcortical pattern of cognitive impairment. Conclusion: Using ultrasound for measuring TCBFV cannot detect evident cerebral hypoperfusion. However, lower TCBFV in SLE patients is associated with more disease activity, but not related to the cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Background: Hyposexuality is one of the most frequent interictal abnormalities observed in patients with epilepsy. Several factors may disrupt normal sexual function in patients with epilepsy, including psychological influences, hormonal disorders, antiepileptic drugs & the disease itself. Objective: The aim of this work is to study the impact of epilepsy management (monotherapy and polytherapy), duration, frequency and types on male sexual function. Methods: This study was carried out on 90 male subjects (50 epileptics with and 20 epileptics without sexual dysfunction and 20 controls).The International Inventory of Erectile Function (IIEF) questionnaire used to assess the patients, sexual functions, assessment of blood levels of sex hormones, electroencephalography, rigiscan and penile duplex. Results: orgasmic function was significantly lower in frontal lobe epilepsy (FLE) than in temporal lobe (TLE) and generalized epilepsy, SHBG was significantly decreased in TLE compared to other groups, there was a highly significant difference between means of sex hormones and sex hormone binding globulin (SHBG) between epileptic patients with, without sexual dysfunction and control groups and lastly, epileptics on monotherapy with or without sexual dysfunction had a highly statistically significant increase in means of dihydroepiandrosterone sulfate( DHEA) compared to those on polytherapy. Conclusion: Sexual dysfunction was more in TLE patients than both FLE and generalized epilepsy, epileptics with sexual dysfunction had a significant variation in their hormonal assay than those without sexual dysfunction, where testosterone (TT) decreased while estradiol and SHBG were elevated, there was no major difference between monotherapy and polytherapy on sexual dysfunction according to sex hormones and IIEF. [ABSTRACT FROM AUTHOR]